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Näslund, Sofie
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Fredriksson, A., Näslund, S. & Behndig, A. (2019). A prospective evaluation of photorefractive intrastromal cross-linking for the treatment of low-grade myopia. Acta Ophthalmologica
Open this publication in new window or tab >>A prospective evaluation of photorefractive intrastromal cross-linking for the treatment of low-grade myopia
2019 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768Article in journal (Refereed) Epub ahead of print
Abstract [en]

Purpose: To evaluate photorefractive intrastromal cross‐linking (PiXL) treatment for low‐grade myopia, comparing three treatment protocols.

Methods: Healthy individuals, 25.6 ± 3.6 years of age, with low‐grade myopia underwent epi‐on PiXL with either: 4‐mm zone treated in high oxygen environment (4 mm‐HIGH; n = 15), 4‐mm/room air (4‐mm LOW; n = 6), or 6‐mm/high oxygen (6‐mm HIGH; n = 6). Efficacy was determined by change in uncorrected visual acuity (UCVA), manifest refractive spherical equivalent (MRSE) and corneal curvature (Kmean) over a 12‐month follow‐up. Safety was determined by best spectacle corrected visual acuity (BSCVA), corneal endothelial cell loss and registration of side‐effects.

Results: Twenty‐seven subjects were included. Due to insufficient effect with the 4‐mm LOW treatment and an unacceptable degree of initial light sensitivity/ocular irritation in the 6‐mm HIGH group, the inclusions to these treatments were stopped after inclusion of 6 patients in each group. The 4‐mm HIGH treatment showed a significantly larger improvement in UCVA (−0.45 ± 0.27 LogMAR) and MRSE (+0.99 ± 0.44 D) at 1, 6 and 12 months compared with the 4‐mm LOW treatment (p < 0.05). At 12 months posttreatment, endothelial cell count and BSCVA were unaltered. More initial side‐effects were noted with the 6‐mm HIGH treatment, compared with the 4‐mm HIGH treatment (p < 0.05).

Conclusion: Epi‐on PiXL may become a safe and effective non‐ablative treatment for low‐grade myopia. The effect is augmented by high oxygen environment and remains stable for 12 months. The initial ocular irritation is acceptable with a 4‐mm treatment zone. The present results justify further clinical studies on PiXL, including refinements of the technique and long‐term results.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
corneal collagen cross-linking, myopia, PiXL, refractive cross-linking
National Category
Ophthalmology
Identifiers
urn:nbn:se:umu:diva-161907 (URN)10.1111/aos.14190 (DOI)000476189700001 ()31301105 (PubMedID)2-s2.0-85069900831 (Scopus ID)
Available from: 2019-08-07 Created: 2019-08-07 Last updated: 2019-08-07
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